Registration

Student Information
Full Name*

First Name Last Name
Hebrew Name
Birth Date*

Month Day Year
Jewish Birthday
Help us figure out the Jewish Birthday!*

born during the dayborn in the evening/night (after sunset)born at dusk/sunset

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

School*
Grade as of September 2023*
Does your child currently attend PS 24 after school program?

YesNo
Is your child currently receiving services? If yes, please specify.
Previous Jewish Education
Check which apply:*

Mother born JewishMother converted
Have there been any conversions or adoptions in the family?*

YesNo
Name of Rabbi who performed the conversion*
Additional Comments
I allow my child's photo to be used on our website and social media/promotional*

YesNo
Parents Information
Father's Name* or guardian

First Name Last Name
Father's Hebrew Name
Father's Cell*

Area Code Phone Number
Father's E-mail*
Mother's Name* or guardian

First Name Last Name
Mother's Hebrew Name
Mother's Cell*

Area Code Phone Number
Mother's E-mail*
Best way to send Hebrew School updates:

Cell PhoneEmailHandout
I am willing to assist in school activities, please contact me
Transportation:*

I would like transportation from PS 24 to Chabad at 2:15I will bring my child to Chabad of Riverdale at 2:30
Pick up information: Pick up is at 4:30 PM at Chabad of Riverdale.
Emergency File
Doctor's name*
Doctor's phone number*

Area Code Phone Number
Allergies *
Medical Conditions*
Emergency Contact*

First Name Last Name
Phone Number*

Area Code Phone Number
Relationship*
Payment
Tuition is $950 for the year - including all supplies.
Financial assistance is available - please call 718-549-1100

Early Bird Discount: Register before June 30th - $100 off
Referal Discount: $100 off for every NEW family that registers through you.
Tuition*

$950
I have a referred a NEW family to register for Chabad Hebrew School.
Name of the family I referred
Payment agreement*

I agree to have the balance of my tuition divided over 2 more payments, on the first of the next 2 months.Click here for Financial Assistance
Total

$0.00

I would like to pay today:Full amount33.33% minimum: $0.00 $

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Should be Empty:

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Student Information

Parents Information

Emergency File

Payment